Clinton Faces Surgery to Remove Scar Tissue After Heart Bypass

By ELISABETH BUMILLER; Carl Hulse contributed reporting for this article.

Published: March 9, 2005

Former President Bill Clinton is to undergo surgery on Thursday to remove fluid and scar tissue from his left chest cavity, some six months after he had a quadruple heart bypass operation, Mr. Clinton and his doctors said on Tuesday. The doctors described the problem, which will keep Mr. Clinton in the hospital 3 to 10 days, as a rare but not particularly risky complication from open-heart surgery.

Mr. Clinton, 58, made the announcement on the same day that he and former President George Bush met with the current President Bush at the White House to report on their recent trip to the Asian nations hit hard by the tsunami last year.

''I feel fine,'' Mr. Clinton told reporters as he stood at former President Bush's side in the Roosevelt Room, shortly after meeting with the current president. Mr. Clinton said that the fluid and scarring problem turned up on a recent X-ray and that the procedure ''will knock me out of commission for a week or two, and then I'll be back to normal.''

He concluded that ''it's no big deal.''

Former President Bush chimed in that on his trip with Mr. Clinton last month to Thailand, Indonesia, Sri Lanka and the Maldives, ''you should have seen him going town to town, country to country, the Energizer Bunny here. He killed me.''

The current President Bush also played down Mr. Clinton's health problems, noting in a brief session with his two predecessors and reporters in the Oval Office that his father and Mr. Clinton had plans to play in an 18-hole charity golf tournament for tsunami victims in Florida on Wednesday.

''Which goes to show how sick he is,'' President Bush said of Mr. Clinton.

Mr. Clinton, who has looked gaunt and pale at some recent public events, had a healthy color and appeared vigorous and in good spirits on Tuesday. He seemed happy to be back in the West Wing, and at one point spent more than two minutes answering a reporter's question about his reaction to spreading demands for democracy and recent elections in the Middle East.

''I think the Iraqi elections went better than any could have imagined, and now, you know, I have said I don't think we ought to pressure the president to get a timetable for withdrawal of American forces, we've got to try to make this work,'' Mr. Clinton said, adding that ''sooner or later'' the Syrians would have to end their occupation of Lebanon, that reporters only write about the problems in the Middle East and that he is ''thrilled'' about recent events in the region.

Former President Bush also answered questions, but kept his answers much shorter.

At a news conference earlier in the day at NewYork-Presbyterian/Columbia University Medical Center, Mr. Clinton's doctors said that the procedure to be performed, called decortication, would require general anesthesia.

Dr. Craig Smith, who performed Mr. Clinton's four-hour bypass operation in September, said that of more than 6,000 bypass surgeries, he has seen only a handful of patients, less then 10, who developed Mr. Clinton's condition.

Mr. Clinton will have the surgery at NewYork-Presbyterian/Columbia, the same hospital where he had his bypass operation. His doctors said that Mr. Clinton had been aware of his condition before he left on his trip to Asia.

The timing of the surgery was considered elective, the doctors said, and once the condition was corrected it was unlikely to recur.

Tammy Sun, Mr. Clinton's press secretary, said in a statement on Tuesday that the scar tissue developed from a build-up of fluid and inflammation that caused compression and a collapse of the lower lobe of Mr. Clinton's left lung.

The statement said that the surgery would be done either through a small incision or with the aid of a thoracoscope, a small device that doctors can insert between the ribs and peer into the chest cavity. The doctors would then drain fluid from the area and peel off a layer of scar tissue.

The statement also said that the fluid buildup and lung collapse has caused Mr. Clinton ''some discomfort'' in recent weeks. But it said that he has otherwise been in ''very good condition,'' recently passed a stress test and is walking up to four miles a day near his home in Chappaqua, N.Y.

In his remarks in the Roosevelt Room, Mr. Clinton said that recent medical tests put him ''in the top 5 percent of men my age in health'' and that the upcoming procedure was ''a routine sort of deal.''

Senator Hillary Rodham Clinton said she would be in New York with her husband for the surgery.

''It is a routine procedure although it is an uncommon complication,'' Senator Clinton said. ''Bill has decided he wants to deal with it and get it behind him, which I feel is the right decision. So on Thursday morning he will go into surgery and it will be taken care of.''

Senator Clinton said that she and her husband were very confident about the outcome. ''We have no reason to believe it is anything other than a routine procedure.''

At the White House, Mr. Clinton and the first President Bush, who have been named by his son to lead fund-raising efforts for tsunami relief, presented a status report of their work so far.

The current President Bush, who held a copy of the report for photographers, said that so far $1 billion in private donations had gone toward relief efforts.

The two former presidents, who have developed what their colleagues say is a good friendship after the bitterness of the 1992 presidential campaign, also praised each other. Mr. Clinton thanked the current president for giving him a chance to work with his father, and the first President Bush said that Mr. Clinton had been ''a joy'' to work with.

The former President Bush, who had been among the first to make a get-well call to Mr. Clinton when he was in the hospital for his heart surgery in September, said about Mr. Clinton's current health problem that ''this thing, whatever he's got, if it knocks you out, it hasn't gotten to him yet.''

Photo: The three most recent presidents yesterday discussing the trip George Bush and Bill Clinton took to South Asian nations last month. (Photo by Doug Mills/The New York Times)(pg. A22)